Artropatía psoriásica complicada con amiloidosis secundaria / Psoriatic arthritis complicated with secondary amyloidosis

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Alternate-day dosing of atorvastatin: effects in treating type 2 diabetic patients with dyslipidaemia.

An analysis is made of the effect of alternateday dosing of atorvastatin and standard once-daily dosing, based on mean low-density lipoprotein (LDL) reduction from baseline in type 2 diabetics. Forty-four type 2 diabetics were enrolled in the study. In compliance with American Diabetes Association (ADA) and National Cholesterol Education Program Expert Panel (NCEP-III) guidelines, LDL-C<100 mg/dl was chosen as the treatment target. Patients were assigned to 10 mg atorvastatin as an initial dose every day. The atorvastatin dose was doubled every 6 weeks if the patients failed to reach the treatment target. After achieving LDL<100 mg/dl, the patients were assigned to the corresponding atorvastatin dose every other day for 12 weeks. Thirty-three patients correctly completed the study. LDL-C decreased 39% after the every-day period and 23% after the alternate-day atorvastatin dosing period (p<0.05). The target LDL-C concentration of <100 mg/dl was maintained in 19 patients (57.6%) in the alternate-day period. None of the 33 patients showed elevations in liver enzymes or creatine kinase during the alternate-day dosing period. Alternate-day dosing of atorvastatin could be an effective and safe alternative to daily-dosing in some type 2 diabetic patients.

Osteoporosis en adulto joven como presentación de cuadro de malabsorción intestinal / Osteoporosis in a young man as the first symptom of intestinal malabsorption

La osteoporosis es una enfermedad con una alta prevalencia en nuestro medio y en nuestros hospitales. La mayoría de estos casos corresponde a casos de osteoporosis primaria. La enfermedad celíaca debe ser considerada en el diagnóstico diferencial de la osteoporosis, pues existe una alta prevalencia de osteoporosis en los enfermos de celiaquía. La osteoporosis además puede ser la única manifestación de enfermedad celíaca del adulto, debiendo considerarse como manifestación y consecuencia de la enfermead celíaca (AU)

Hiperparatiroidismo asociado al tratamiento con litio / Hyperthyroidism associated with lithium treatment

El tratamiento prolongado con litio puede ocasionar alteraciones endocrinológicas.Presentamos el caso de una paciente que desarrolló un hiperparatiroidismo secundario al tratamiento con carbonato de litio, lo que constituye un hecho poco frecuente (AU)

Otitis media y bacteriemia / Otitis media and bacteremia

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[Polyarteritis nodosa associated with hepatitis C virus]. / Panarteritis nodosa asociada al virus de la hepatitis C.

BACKGROUND: To study the seroprevalence of hepatitis C virus in a cohort of six patients with a diagnosis of polyarteritis nodosa (PAN). METHODS: There have been included six patients with a diagnosis of PAN, carrying out a serodiagnosis of hepatitis B virus (VHB) and C (VHC) this last one by means of the following methods: ELISA, RIBA-II and PCR. RESULTS: These cases (50%) showed exclusive positivity to VHC by means of the three ways of diagnosis, two cases showed positivity to VHB (33.3%), one case (16.6%) showed positivity to both virus (VHB and (VHC) and one case didn't show positivity virus. CONCLUSIONS: It is probable a ethipatogenic relation between hepatitis C virus and polyarteritis nodosa, our sample doesn't show any difference from that written in the literature. The positive rheumatoid factors can give false positive for VHC by means of the technique ELISA because of this it is necessary to confirm the positive by means of the techniques RIBA-II and PCR.

[Pancreatic disease in patients with HIV treated with didanosine (DDI)]. / Afectación pancreática en pacientes VIH tratados con didanosina (DDI).

Pancreatic involvement has been studied in 70 HIV infected patients, in diverse stages, that were treated with didanosine (ddI), both as monotherapy or associated to zidovudine; 38% of patients presented adverse reaction that obliged to withdraw the medication: pancreatitis (4%), hyperamylasemia (21%) and abdominal pain and/or diarrhea (12%). The possible causes in presentation of adverse effects were evaluated: route of infection, stage of HIV infection, use of pentamidine or trimethoprim-sulfamethoxazole for preventing Pneumocystis carinii pneumonia, administration of ddI in monotherapy or in combined form with zidovudine, time of treatment and level of CD4 lymphocytes. The outcome of adverse effects is related significantly only with the most advanced stage of HIV infection.

[Splenic abscess following gynecologic infection with complete response to antibiotic treatment]. / Absceso esplénico tras infección ginecológica con respuesta completa al tratamiento antibiótico.

A 37 year old woman is presented with solitary splenic abscess, without involvement of other organs, in the context of septic abortion. Splenic abscess were effectively treated with 21 days of antibiotic administration, not was necessitated splenectomy and percutaneous drainage. Emphasis is laid on its rarity of solitary splenic abscess in the course of gynecologic infection, and complete response to antibiotic treatment.

[Cholecystectomy: a choice technique in biliary microlithiasis]. / La colecistectomía: técnica de elección en la microlitiasis biliar.

The purpose of our study is to show results obtained after a cholecystectomy on 25 patients in order to present a suggestive clinic of bile origin and a positive result for determination of microcrystals in the bile probe even in the case of negative radiologic diagnoses (echography, cholecystography). Out of 25 patients operated on the following results were obtained: microscopic cholelithiasis in 12, granular cholelithiasis in 3, acute cholecystitis in 2, cholesterolosis in 2 and without pathologic findings in 6 patients after an observation period of 24 months following the operation it was demonstrated that almost all the patients (96%) had no symptoms. On the other hand, the above mentioned results are compared to the findings obtained during an observation period of a group of 34 patients with positive probe results with the same clinic characteristics and not having been operated on refusing the operation suggested.

[Diagnostic value of duodenal drainage in patients with biliary symptoms and negative imaging test]. / Valor diagnóstico del sondaje duodenal en pacientes con clínica biliar y test de imagen negativo.

A group of patients with clinical manifestations suggesting biliary origin in whom diagnostic imaging techniques were negative were studied by duodenal biliary drainage with the aim of identifying whether microcalculi were present in the bilis being responsible for the symptomatology. The problem group was made up of 96 patients with the results being compared with those of a control group (without biliary disease) including 45 subjects. Duodenal biliary drainage was analyzed for the detection of microlithiasis in the biliary sediment in all the subjects. The analysis was positive in 46 (47.9%) of the patients with biliary clinical manifestations while analysis was positive in only 5 (11.2%) of the control group with the differences being statistically significant. Seventeen of the 46 positive patients underwent surgery demonstrating biliary disease in all (chronic cholecystitis). All these patients remained asymptomatic except one on follow up with 94.1% cure by cholecystectomy being achieved. The authors conclude that duodenal biliary drainage is a highly profitable, complication-free and easily performed diagnostic technique for the detection of microlithiasis which should be regularly used in patients with symptoms suggestive of biliary origin and complementary negative explorations.